1. Improving Mental Health Services Dennis Dewar – PALS Co-ordinator

2. Who are we? Halton Knowsley St Helens Wigan Warrington

3. What we do Assessment service Home treatment service (adult MH) Recovery service (adult MH) Adult inpatients (33 beds) Tier 3 Child and Adolescent Mental Health (CAMHS) A&E Liaison & Ward Liaison (pilot) – both at WHHFT Early Intervention in Psychosis Learning Disabilities – inpatients (2 beds) and community services Later Life and Memory Services (LLAMS) Older Persons Acute Inpatients (14 beds) Asperger's assessments ADHD Criminal Justice Liaison Service Operation EMBLEM (Street Triage)

4. Mental Health Problems in Warrington From bottom: 1, 2 & 4 –estimated no. people based on 2013 mid-year population estimates (ONS). 3, 5, 6, 7 actual number at a point in time Adults reporting low emotional wellbeing 1 in 4 (39,000 people) 1 in 16 (10,300 people) 1 in 260 (790 people) 1 in 6 (27,300 people) 1 in 3,200 (75 people ) 1 in 18 (9,150 people) On GP register with diagnosis of depression (aged 18+) Subject to Mental Health Act On CPA (Care Programme Approach ) Had suicidal thoughts at some point in their lives Attempted suicide at some point in their life Suicides 1 in 10,900 (average 18 suicides per year)

5. The ghost of Service user involvement - Past

6. True or false - Before the mid-eighteen hundreds, common belief was that those who suffered from mental illness suffered because they had a "disease of the soul"

7. Mental Health Treatment – true or false?

8. True - The Rotary Chair "would be turned on its axis at very high velocity … caused extreme discomfort and fright … and the sensation of suffocation" The idea was to reset the patient's equilibrium and brain.

9. In which year did homosexuality cease to be classified as a mental disorder by the World Health Organisation?

10. 1992

11. True or false - In the Victorian era the word Hysteria became the general term for women with mental illness and cures included bed rest, seclusion, bland food, refrain from mental activities (such as reading), daily massage, and sensory depravation.

12. Mental Health Treatment – Deep insulin injection, - true or false?

13. True – it induced a coma. Winwick, 1950’s

14. “Those who cannot remember the past are condemned to repeat it.” George Santayana Which of today’s practices will appear barbaric to our grand-children?

15. Patient Experience NHS Friends and Family Test Patient Advice Liaison Services (PALS) Compliments, Complaints and Incidents Sharing Lived Experiences. Technology including Kiosks and Trust website Patient Opinion posting Service Users and Carers Forums Quality Inspections, Patient Meetings, etc.) Other Feedback (Healthwatch, National Patient Survey, etc.)

17. Changes – You Said, We Did You said you need more cups on the ward. Why is smoke break after our evening meal? You were not informed that the Advocacy Service was on the ward. Cups have been ordered. Time of smoke break has been changed. Advocacy posters are now on display and it will be agenda item at ward meeting.

18. Any questions?